Otoplasty

Otoplasty - Page

Also known as Ear Pinning

What is Otoplasty?

Otoplasty is most commonly performed between five and fourteen years of age in children. In fact, ear pinning is one cosmetic surgery where “earlier is better” because of the potential for psychological damage to a child’s self-esteem. The optimal time for performing otoplasty in children is just before they start school, or at about the age of five, when the ear is over 85% of the adult size.

Anatomy of the Ear

What to expect during the Otoplasty procedure?

Bilateral otoplasty usually takes about two hours. After 12 to 13 years of age unless there are special circumstances, otoplasty can be performed under local anesthesia with or without oral sedation, in an office setting, in a minor operating room. In most cases, surgery will leave a faint scar in the back of the ear that will fade with time. Even when only one ear appears to protrude, surgery is usually performed on both ears for a better balance.

Correcting Ears that Stick Out

The first problem associated with the prominent ear is the relative absence of the superior crus of the antehelical fold. This is the upper limb of the ‘y’ shaped fold which travels inside the helix (the outer folded rim ) from below to upwards and from back to the front at the top half of the ear.

The most common surgical correction for this problem is the “Mustarde Procedure”, which involves placing an incision behind the ear and then creating a tunnel to the front of the ear and over the cartilage which lacks the necessary fold and then scoring that cartilage, to remove it’s ‘spring’ and then finally placing a set of lasting sutures in the cartilage on the back side of the eat such a way to create a deeper convex fold at the front of the ear.

Correcting the Oversized Conchal Bowl

The second problem associated with the prominent ear, which is often overlooked, is the relative oversized and deep conchal bowl. The conchal bowl is the deep central area of the ear, just behind the ear canal. The ‘Concha’, as it’s latin name infers, is shell like. If the shell is too deep and large, it will literally project the entire ear from the temple.

The concha of the ear is an irregular hemispheric bowl with a defined rim. The normal scapha–helix surrounds the posterior part of the bowl (much as the brim of an inverted hat surrounds the crown). The pitch at which the scapha–helix projects from the conchal cup is determined: (i) by the acuteness of the fold of the crest of the antihelix, (ii) by the height of the posterior wall of the conchal bowl, and (iii) by the completeness of the hemisphere formed by the concha. If the posterior wall of the concha is excessively high, and the concha is excessively spherical, then there is an excessive angle and distance between the plane of the scapha–helix and the plane of the temporal surface of the head.

What to expect during the recovery for the Otoplasty procedure?

A gentle pressure dressing is placed on the head to provide slight pressure on the ears and maintain their new position as well as to minimize swelling and excessive fluid accumulation beneath the skin. This dressing will be removed in 5-7 days. All incisions are closed with stitches that dissolve and don’t have to be removed. Patients can wash their hair as soon as your head dressing is removed. A comfortable cloth band or hat is worn to train the ears to remain close to the side of the head ideally for 6 weeks or a minimum of 10 days.

Examples of Otoplasty Results:

Request a consultation.

To find out more about available treatments and procedures, request a consultation with Dr. Moulton-Barrett at one of his Bay Area offices. Board certified plastic surgeon Rex Moulton-Barrett, M.D., offers advanced care and procedures for Bay Area residents. He has offices in Oakland, San Leandro, Alameda and Brentwood, CA.

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